Popular prostate drugs linked to increased risk of deadly disease

When you think about the invasive conventional treatments for an enlarged prostate, it’s really no wonder men turn to drugs to manage their condition instead.

Think about it. You have transurethral needle ablation (TUNA)—an outpatient surgery that involves insertion of a thin tube through the tip of your penis in order to place tiny needles in your prostate. The needles then emit radio waves designed to shrink prostate tissue.

Then there’s transurethral microwave thermotherapy (TUMT), which also involves inserting a small tube through your penis. But in this case, it’s a microwave antenna that emits energy to heat up and destroy excess prostate tissue.

And finally, there’s transurethral resection of the prostate (TURP)—the “gold standard” of prostate surgery. Urologists call it “Roto-Rooter surgery,” which pretty much tells you everything you need to know: Doctors insert an instrument though your penis and cut away the section of the prostate that’s blocking urine flow.

So I can see why a daily dose of a 5-alpha-reductase inhibitor (like finasteride) is preferable to a tube up your penis and a needle in your prostate. But let me be clear… these drugs invite plenty of other health problems.

The risks outweigh the “benefits”

These drugs are designed to reduce the production of hormones that increase prostate size and lead to benign prostatic hyperplasia (BPH).

But it can take up to a year before you really notice an improvement in urinary symptoms like urgency, night frequency, and incomplete bladder voiding. In the meantime, you may experience a decreased sex drive and difficulty getting an erection.

And according to one new study, that’s just the tip of the iceberg…

Researchers analyzed the health records of more than 50,000 U.K. patients, all taking 5-alpha-reductase inhibitors, over the course of 11 years. Results showed that the drugs increase the risk of type 2 diabetes by roughly a third.1

And when the team repeated the study using the health records of a group of Taiwanese men, they observed the same trend. So clearly, we’re not talking about a fluke.

But naturally, researchers say that patients shouldn’t stop taking the drugs, and that guidelines don’t need to change—rather, doctors need to monitor their patients more closely for early signs of diabetes. Give me a break!

A 30 percent increase in risk isn’t exactly small. And frankly, this latest finding should give anyone pause—especially when you consider it’s not the first to observe changes in metabolism and insulin response with these drugs.

If nothing else, it’s a compelling reason for men with BPH to seek alternatives to help manage their urinary issues. Because the fact is, there are a lot of safe, natural options for relief out there.

Risk-free support for a stronger flow

Let’s start with saw palmetto—probably the most popular prostate supplement, and one that even most conventional doctors are familiar with.

Of course, they’ll probably point out that its benefits against BPH symptoms are a mixed bag. (That’s if they concede that it does anything at all.) But this misses the bigger point.

Saw palmetto is proven to support normal prostate size and function. And it can help address prostate inflammation, which is another potential contributor to BPH.2 That’s why I generally recommend 320 mg, once or twice daily, depending on the patient.

But that’s not all I recommend. While saw palmetto is a slam dunk for prostate support, it doesn’t do a whole lot for bladder or urinary tract health. And needless to say, that’s just as important in managing BPH.

That’s why I also recommend cranberry extract. Women have been using it to ward off urinary tract infections for ages—but research shows it also offers critical support for men.3

In fact, one 2010 study published in The British Journal of Nutrition showed that cranberry powder delivered significant improvements in the International Prostate Symptom Score, rate of urine flow, average flow, total volume, and post-void residual urine volume.

So I generally recommend at least 1,000 mg of cranberry extract daily—in supplement form only (the juice is loaded with way too much sugar).

Tea extracts are also helpful. In one study of 46 men, a green and black tea extract increased urine flow and reduced the amount of urine left in the bladder after voiding in as little as six weeks.4 Patients took either 500 mg or 1,000 mg daily. And both dosages showed a positive effect.

Stinging nettle also appears to be effective in reducing BPH symptoms, likely due to its ability to modulate hormones and reduce inflammation.5 (In other words, it works like 5-alpha-reductase inhibitor drugs… but without the risks and side effects.)

This is a common ingredient in prostate health supplements, where lower dosages will do the trick. But I recommend up to 300 mg twice daily as a stand-alone supplement.

Finally, I’m a big fan of Pygeum africanum extract, otherwise known as the African plum tree. A large review of studies shows this botanical can do it all when it comes to BPH symptoms—it increases urine flow by 23 percent, reduces leftover urine in the bladder by 24 percent, and lowers the incidences of middle-of-the-night urination by 19 percent.6

A safe, general dose as a stand-alone supplement is 100 to 200 mg daily. But once again, smaller doses can go a long way when combined with other supportive nutrients.


  1. Wei L, et al. “Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: population based cohort study.” BMJ. 2019 Apr 10;365:l1204.
  2. Sirab N, et al. Lipidosterolic extract of serenoa repens modulates the expression of inflammation related-genes in benign prostatic hyperplasia epithelial and stromal cells. Int J Mol Sci. 2013 Jul 10;14(7):14301-20.
  3. Mathison BD, et al. Consumption of cranberry beverage improved endogenous antioxidant status and protected against bacteria adhesion in healthy humans: a randomized controlled trial. Nutr Res. 2014 May;34(5):420-7.
  4. Katz A, et al. A green and black tea extract benefits urological health in men with lower urinary tract symptoms. Ther Adv Urol. 2014 Jun;6(3):89-96.
  5. Chrubasik JE, et al. A comprehensive review on the stinging nettle effect and efficacy profiles. Part II: urticae radix. Phytomedicine. 2007 Aug;14(7-8):568-79.
  6. Ishani A, et al. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. Am J Med. 2000 Dec 1;109(8):654-64.